Developing a Medical Institution Management System through Promoting Social Accountability

The paper regards the implementation of social accountability principles into the system of medical institution management as the target of research. The process of personnel management is viewed as its research subject. The paper aims to develop the system of incentives for medical institution personnel based on the principles of social accountability. The research methods and tools applied in the study are analysis of content and internal enterprise documentation, staff member interviews and statistical methods of data processing. The expected research outcome is the implementation phase of the social accountability management system resulted in the development of the Code of corporate conduct. The article advocates the view, that the Code of Conduct should be based on the diagnosis of the state of corporate culture and motivate employees of the organization. The management team of medical institution can set their own social and reasonable quality management system, which will enable it to promote and involve staff in the process of improvement

Lattice dependence of saturated ferromagnetism in the Hubbard model

We investigate the instability of the saturated ferromagnetic ground state (Nagaoka state) in the Hubbard model on various lattices in dimensions d=2 and d=3. A variational resolvent approach is developed for the Nagaoka instability both for U = infinity and for U < infinity which can easily be evaluated in the thermodynamic limit on all common lattices. Our results significantly improve former variational bounds for a possible Nagaoka regime in the ground state phase diagram of the Hubbard model. We show that a pronounced particle-hole asymmetry in the density of states and a diverging density of states at the lower band edge are the most important features in order to stabilize Nagaoka ferromagnetism, particularly in the low density limit.Comment: Revtex, 18 pages with 18 figures, 7 pages appendices, section on bcc lattice adde

Quasi-Periodic Pulsations in Solar Flares: new clues from the Fermi Gamma-Ray Burst Monitor

In the last four decades it has been observed that solar flares show quasi-periodic pulsations (QPPs) from the lowest, i.e. radio, to the highest, i.e. gamma-ray, part of the electromagnetic spectrum. To this day, it is still unclear which mechanism creates such QPPs. In this paper, we analyze four bright solar flares which show compelling signatures of quasi-periodic behavior and were observed with the Gamma-Ray Burst Monitor (\gbm) onboard the Fermi satellite. Because GBM covers over 3 decades in energy (8 keV to 40 MeV) it can be a key instrument to understand the physical processes which drive solar flares. We tested for periodicity in the time series of the solar flares observed by GBM by applying a classical periodogram analysis. However, contrary to previous authors, we did not detrend the raw light curve before creating the power spectral density spectrum (PSD). To assess the significance of the frequencies we made use of a method which is commonly applied for X-ray binaries and Seyfert galaxies. This technique takes into account the underlying continuum of the PSD which for all of these sources has a P(f) ~ f^{-\alpha} dependence and is typically labeled red-noise. We checked the reliability of this technique by applying it to a solar flare which was observed by the Reuven Ramaty High-Energy Solar Spectroscopic Imager (RHESSI) which contains, besides any potential periodicity from the Sun, a 4 s rotational period due to the rotation of the spacecraft around its axis. While we do not find an intrinsic solar quasi-periodic pulsation we do reproduce the instrumental periodicity. Moreover, with the method adopted here, we do not detect significant QPPs in the four bright solar flares observed by GBM. We stress that for the purpose of such kind of analyses it is of uttermost importance to appropriately account for the red-noise component in the PSD of these astrophysical sources.Comment: accepted by A&

LICC: L-BLP25 in patients with colorectal carcinoma after curative resection of hepatic metastases--a randomized, placebo-controlled, multicenter, multinational, double-blinded phase II trial

Background: 15-20% of all patients initially diagnosed with colorectal cancer develop metastatic disease and surgical resection remains the only potentially curative treatment available. Current 5-year survival following R0-resection of liver metastases is 28-39%, but recurrence eventually occurs in up to 70%. To date, adjuvant chemotherapy has not improved clinical outcomes significantly. The primary objective of the ongoing LICC trial (L-BLP25 In Colorectal Cancer) is to determine whether L-BLP25, an active cancer immunotherapy, extends recurrence-free survival (RFS) time over placebo in colorectal cancer patients following R0/R1 resection of hepatic metastases. L-BLP25 targets MUC1 glycoprotein, which is highly expressed in hepatic metastases from colorectal cancer. In a phase IIB trial, L-BLP25 has shown acceptable tolerability and a trend towards longer survival in patients with stage IIIB locoregional NSCLC. Methods: This is a multinational, phase II, multicenter, randomized, double-blind, placebo-controlled trial with a sample size of 159 patients from 20 centers in 3 countries. Patients with stage IV colorectal adenocarcinoma limited to liver metastases are included. Following curative-intent complete resection of the primary tumor and of all synchronous/metachronous metastases, eligible patients are randomized 2:1 to receive either L-BLP25 or placebo. Those allocated to L-BLP25 receive a single dose of 300 mg/m2 cyclophosphamide (CP) 3 days before first L-BLP25 dose, then primary treatment with s.c. L-BLP25 930 mug once weekly for 8 weeks, followed by s.c. L-BLP25 930 mug maintenance doses at 6-week (years 1&2) and 12-week (year 3) intervals unless recurrence occurs. In the control arm, CP is replaced by saline solution and L-BLP25 by placebo. Primary endpoint is the comparison of recurrence-free survival (RFS) time between groups. Secondary endpoints are overall survival (OS) time, safety, tolerability, RFS/OS in MUC-1 positive cancers. Exploratory immune response analyses are planned. The primary endpoint will be assessed in Q3 2016. Follow-up will end Q3 2017. Interim analyses are not planned. Discussion: The design and implementation of such a vaccination study in colorectal cancer is feasible. The study will provide recurrence-free and overall survival rates of groups in an unbiased fashion. Trial Registration EudraCT Number 2011-000218-2

Spatial processing of visual information in the movement-detecting pathway of the fly

1. Spatial processing of visual signals in the fly's movement-detecting pathway was studied by recording the responses of directionally-selective movement-detecting (DSMD) neurons in the lobula plate. The summarized results pertain to a type of neuron which preferentially responds to horizontal movement directed toward the animal's midline. Three kinds of visual stimuli were used: moving gratings, reversing-contrast gratings and reversing-contrast bars.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47087/1/359_2004_Article_BF00613743.pd

Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference